Cardiopulmonary Impact of the Minimally Invasive Repair of Pectus Excavatum (MIRPE) in Pediatric Patients | Feb 2021 - Mar 2023 | Single Center | Prospective-pilot study | 25 patients presented for pectus bar removal and completed post-MIRPE CPET* | 72 % male | Median age 18.6 years | Assessment: *CardioPulmonary Exercise Testing (CPET) conducted pre-MIRPE and post-bar removal | -O₂ Pulse: 10.3 → 12.1 mL/beat (p = 0.004) | -% Predicted O₂ Pulse: 79.5% → 84.4% (p = 0.046) | -Peak VO₂/kg: NO significant change | -Peak-VO2 (ml/min): Increased | Conclusion: MIRPE leads to an increase in O₂ Pulse, improving heart performance and stroke volume by relieving cardiac compression | https://pubmed.ncbi.nlm.nih.gov/39854987/ | Eldredge RS et. al. | Division of Pediatric Surgery, Mayo Clinic School of Medicine and Science, AZ, USA | @LizzyPAC8 | @globalcastmd | @LizzyPAC8 | @StayCurrentMD | Cincinnati Children's | Journal of Pediatric Surgery
Cardiopulmonary Impact of the Minimally Invasive Repair of Pectus Excavatum in Pediatric Patients: A Prospective Pilot Study
Infographic · Jun 2025 · 1 min read
In brief
In brief
Prospective study of 25 pediatric patients demonstrates that minimally invasive pectus excavatum repair significantly improves O2 pulse (a stroke volume surrogate), suggesting relief of cardiac compression. While stroke volume improved post-operatively, overall exercise capacity showed variable results, highlighting the multifactorial nature of cardiopulmonary function in this population.
- MIRPE significantly increases O2 pulse (10.3 to 12.1 mL/beat), suggesting improved stroke volume and relief of cardiac compression
- Peak VO2/kg remains unchanged post-repair despite stroke volume improvements, indicating multifactorial exercise capacity determinants
- Patients with decreased activity levels at bar removal show reduced peak VO2/kg compared to pre-operative baseline
- Cardiopulmonary benefits of pectus repair are measurable but limited—stroke volume improves without proportional exercise capacity gains
- CPET provides objective metrics for counseling families on realistic functional outcomes following pectus excavatum correction
Written by the GCMD Library team from the infographic.
The infographic uses a teal, gray, and yellow color scheme with anatomical illustrations of a ribcage and heart, plus a cartoon figure of a young person with a backpack. Data is presented in sections with arrows showing pre- and post-procedure measurements. Statistical results are highlighted in different colors to indicate significance levels.
R Scott Eldredge, Arash Sabati, Brielle Ochoa, Vijay Viswanath, Emily Khoury, Kristin Rassam, Daniel J Ostlie, Justin Lee, Lisa McMahon, David M Notrica, Benjamin E Padilla
Introduction: The physiologic benefits of the minimally invasive repair of pectus excavatum (MIRPE) on cardiopulmonary function are poorly understood in pediatrics. We sought to examine the effects of MIRPE on exercise response during cardiopulmonary exercise testing (CPET).
Methods: A prospective-pilot study was conduct of patients ≤18 years who presented for pectus bar removal. All patients had CPET prior to MIRPE and following bar removal. Paired sample T tests were used to compare pre- and post-MIRPE CPET results.
Results: Twenty-five patients completed post-MIRPE CPET (72 % male, median age 18.6 [IQR:17.5-19.8]). The median Haller and correction indices were 4.5 and 29.4 %, respectively. There was significant increase in O2Pulse, (10.3 vs 12.1 mL/beat, p = 0.004), and percent predicted O2Pulse (79.5% vs 84.4 %, p = 0.046) following MIRPE/bar removal. The peak-VO2/kg and did not change significantly following MIRPE/bar removal; however, peak-VO2 (ml/min) increased. Patients with decreased activity levels at time of bar removal compared to pre-MIRPE had decreased peak-VO2/kg and predicted peak-VO2/kg.
Conclusion: Following MIRPE, patients experience increased in O2Pulse, which is a surrogate measure of stroke volume response to exercise and may reflect relief of cardiac compression. Cardiopulmonary function is multifactorial and despite improvement in stroke volume, other factors may impact exercise capacity (VO2) following MIRPE.